Liposuction is a method of correcting the contours of the body by vacuum removing the accumulations of adipose tissue. Despite a wide variety of liposuction methods, they are united by a simple and completely understandable principle.
Through a special tube called a cannula, which is placed in the subcutaneous space, the excess of adipose tissue is removed under pressure created by a special apparatus.
There are methods for removing fat, not with a vacuum-aspirator, but with special syringes, while the operation time is significantly increased.
The entire fat mass in the human body is divided into three layers, which differ not only in localization, but also in the characteristics of metabolism.
The 1st layer is the surface layer. It is located right under the skin. The harmony of the outlines and proportions of the body depends on the intensity of this layer. It is located on all parts of the body without exception, considerably varying in density and thickness. This layer can be modified with the help of all types of liposuction.
The 2nd layer is deep. It is located under the muscular fascia. The main feature of this layer is that it is less prone to decrease with total weight loss. Liposuction is virtually impossible.
3rd layer – internal (visceral) fat. It is located inside the abdominal cavity. It can not be removed with liposuction. The pronounced hypertrophy of this layer is more typical for men, which is expressed in the form of large, convex, so-called “beer” bellies.
It is believed that in an adult the number of adipocytes (fat cells) is constant. In other words, obesity is not related to an increase in their number, but with an increase in their volume.
Obesity is divided into two types: local and generalized.The local form of obesity does not react to physical exercises and diets. It is much more common in women, it has rather distinct contours and a characteristic “registration”: the outer and inner upper parts of the thighs, the inner surface of the knees, the flanks, the anterior abdominal wall area, the chin area and so on. This form of obesity is the main indication for liposuction with aesthetically favorable outcome.
The generalized form of obesity is the result of a metabolic disorder caused by genetic, constitutional factors or an improper diet and exercise. With this form of obesity, adipocyte hypertrophy of all layers occurs. Outwardly, a person with this form of obesity resembles a sumo wrestler.
Similar violations are practically useless to solve with the help of liposuction, but should be treated with conservative methods with the involvement of therapists, endocrinologists and nutritionists.
As already mentioned above, the main indication for liposuction is the presence of local forms of obesity with a violation of the contours of the figure. The most common in women is the trophy-shaped deformity of the hips, which is created by fat “traps” located on the outer surface of the thighs. Less significant in size, but no less important in its effect on the hip line, are the fatty “traps” located on the inner surface of the knee joint. These “traps”, as a rule, are combined with fatty deposits located in the region of the hip, pelvis, abdomen and flanks.In patients with significantly increased body weight requires a separate explanation of the fact, that liposuction is aimed precisely at correcting the contours of the body, and not to reduce body weight. The latter is achieved only to a certain extent, but is rather a logical consequence of the removal of a huge number of adipocytes than the purpose of the operation.
The main purpose of liposuction, performed with local forms of obesity, is the correction of the contours of the body. At the same time, when discussing the possible results of the operation with the patient, the surgeon should emphasize, that the main task of the intervention is not to create an ideal body, but to achieve a marked improvement in comparison with the initial state.
What is the process of preparation for surgery? The patient should be healthy (no cold or other diseases during this period). It is necessary to have general clinical examinations (blood tests, urine tests, fluorography of the thoracic cavity organs, ECG). If you smoke, you should quit smoking for at least 2 weeks. Before surgery and to refrain from smoking after it for at least 2-3 weeks. Otherwise, the risk of wound healing is sharply increased due to the fact that smoking significantly reduces the flow of blood into the vessels of the skin. If you are taking any medications, you should discuss this with your doctor.
Contraindications to liposuction:
- severe chronic somatic diseases,
- Endocrine obesity,
- pronounced violations of skin elasticity.
As for the operation, it is usually performed under general anesthesia, although it is possible to perform liposuction under local anesthesia provided that a small area is treated, and the patient is “morally” prepared for this.
Fat is removed through small holes in the skin with the help of thin metal cannulas and a special suction.
The places of the incisions are chosen in such a way that they are hidden further from the eyes (natural folds of the body, the zone of wearing underwear). The end of the cannula is attached to the vacuum device: it creates a negative pressure, which ensures the removal of fat.
Progressive fan-shaped movements of the cannula (forward-backward) lead to mechanical destruction of adipose tissue and its vacuum aspiration. For a wide range of readers, it may be more understandable to compare the procedure for removing fat with the process of eliminating dust through a vacuum cleaner.Not all areas of the body can undergo liposuction with good results. These “forbidden zones” include: upper and middle third of the back, lower legs, front thighs.
After liposuction, you need to wear special compression underwear for 1.5-2 months, to prevent the formation of bruises and sagging skin. Pregnancy is not recommended, at least for 6 months after operation.
Within 2 weeks it is recommended to stay on a low-salt diet, and also not take aspirin or aspirin-containing or blood thinning medications. Social activity should be limited for approximately 10 days after the operation. For one month, it is necessary to exclude sports and any other excessive physical activity, do not sunbathe in the sun and do not use saunas and baths.
Postoperative period is characterized by a number of features:
- in the operation zone, seals can form, which gradually decrease and disappear within a few months.
- formation of bruising (bruising) at the site of surgery, which disappear within 2-4 weeks.
- sometimes unpleasant or painful sensations are possible, which can be amplified by movements or physical activity, as a rule such disorders disappear on their own during the first days after the operation.
- there is a possibility that after the operation the contours of the body and the surface of the skin can become uneven. These changes can be eliminated within a few months after the operation, and sometimes remain, and this requires a second operation. The uneven contours of the body and the skin surface can be preserved after surgery in patients with cellulite or lipodystrophy.
- In patients with large fat “traps”, and a thin skin, when removing a significant amount of adipose tissue, skin may hang. In women who give birth with the removal of adipose tissue in the abdomen, relaxation of the skin can intensify.
As with all surgical interventions, after liposuction, it is possible to develop any general surgical complications, as well as the following complications specific to this operation:
- in very rare cases, the development of an inflammatory process is possible, for the treatment of which an additional operation with skin incisions in the operated region may be required;
- also a rare complication is the necrosis of the skin in the area of the operation, which sometimes requires repeated operations.
Will the fat cells grow back after liposuction?
Liposuction removes fat cells permanently. The fat cells that are removed by liposuction can never come back, however. Since the number of fat cells in an adult person is constant. When liposuction occurs a mechanical removal of adipocytes, the new cells do not grow.
However, one of the mandatory conditions for maintaining a stable aesthetic result for patients who underwent liposuction is tightening the diet. Since liposuction does not affect human metabolism, in particular, lipid metabolism. Therefore, improper disposal of fat and carbohydrates from food will continue to provoke swelling of fat cells in places that have not undergone liposuction.This can lead to a disproportionate deposition of adipose tissue, and a pronounced imbalance between parts of the body exposed and not subjected to liposuction.
Therefore, if the patient maintains a constant weight, the operation gives the optimal result.
If the patient is gaining excess weight, then as with other cosmetic operations, the result is always worse.
However, in this case, the place of the former traps, the new fat tissue is deposited more evenly than before liposuction.
Also the frequently asked question is – how will the skin behave after the liposuction surgery? In the vast majority of cases, the skin after liposuction tends to contract. In simple words, it contracts and fills the defect that formed after the removal of fat. Alas, there is one thing: for those who suffer from a problem of reduced skin elasticity or are obese, the problem of post-operative skin contraction becomes more than relevant.
In this case, an excess of skin can be formed after the operation, which, in the case of a large amount of removed fat, will hang. In these cases it is necessary to resort to surgical tightening of the skin, which, unfortunately, leads to the formation of large scars. Therefore, at the first consultation, the patient and the doctor should discuss this point.
Another very interesting question – How Much Fat Can the Liposuction Remove Safely in One Session? This issue is the subject of heated discussions in professional circles, because there is no clear answer to it.
Some doctors say that removing 1.5 kg (3 lb 4 oz.). fat refers to large volume operations. Others successfully remove up to 10kg (22 lb 3/4 oz.) fat. There are data on the removal of 16 kg (35 lb 4 oz.) fat. At present, it is customary to distinguish small volume liposuction (with removal to 1.5-2.5 liters of fat), a large volume (2.5-5 liters of fat) and a super-large volume (more than 5 liters of fat).Liposuction of small volume can be performed under local anesthesia and in outpatient settings. Liposuction of large volume requires hospitalization of the patient for 1-3 days. Ultimately, each surgeon decides on the scope of the operation, based primarily on his personal experience. But the golden rule of surgery has no alternative: it is better to perform two relatively safe operations than one really dangerous for the life and health of the patient.
Operation time: 1-2 hours or longer.
Anesthesia: Local, combined intravenous or general anesthesia.
Location: Surgical hospital. The period of hospitalization is 1-3 days, depending on the number of treated areas and the amount of fat tissue to be removed.
Places of incision and details of liposuction: Several small incisions of 2 – 5 mm. Placed in inconspicuous areas, along the periphery of the cultivated zones.
Possible side effects: Swelling and bruising, in places, a decrease in sensitivity.
Risks: Infection, asymmetry, uneven contours, hyperpigmentation, bruises, seromas (fluid accumulation under the skin).
Recovery: It is mandatory to wear compression underwear for 4-6 weeks after the operation. Sutures are removed after 7 days. Usually the patient can return to work after 5-14 days. Physical activity can be resumed no earlier than 3-4 weeks. Swelling and bruising disappear within 1-2 weeks, and possible seals dissolve within 3-6 months.
Result: After liposuction, a permanent result is achieved. However, obvious non-compliance with diet and hormonal disorders can cause an increase in the volume of remaining fat cells.
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